State Health Plan obesity-surgery results coming in

COLUMBIA — The results from South Carolina’s obesity-surgery pilot program will be gathered this year from the 100-patient experiment in cost-cutting.

In January of last year, obese patients who were enrolled in the State Health Plan jockeyed for a spot in the $2.4 million pilot program for state-funded bariatric surgery. It was a novel response to an expensive health care problem, and some questioned whether it would truly cut health care costs by preventing other obesity-related conditions, such as diabetes.

Ella McFadden is one who hopes South Carolina’s State Health Plan extends its controversial bariatric surgery pilot program.

“My fingers are crossed,” said McFadden, who has two daughters in their 20s and a 5-year-old grandson, and owns a home-care agency. She said has been trying to lose weight for years, and her doctor finally recommended surgery.

“I was reading up on obesity and gastric bypass, and I’m like, ‘oh, wow, I didn’t even know about this,’” said McFadden, referring to the state pilot program. But the application deadline had already passed.

The Manning woman, whose husband is in law enforcement and covered by the State Health Plan, said her BMI is greater than 40. She’s struggled with her weight since childhood and today must manage her blood pressure.

BlueCross BlueShield of SC, the third-party claims processor for the State Health Plan, is currently monitoring the progress of the pilot participants, said Megan Lightle, interim media contact for the S.C. Public Employee Benefit Authority, on Monday.

As for the results of the surgeries, Lightle said by the end of this year the claims received to date may begin to offer a partial indication of the results of the pilot, but a complete picture will not emerge until sometime in 2014.

Lightle said the General Assembly will receive aggregate information and data, such as before-and-after comparisons of medical and prescription costs and data about any complications. The information will also be available to the public.

Nevertheless, she said it’s unknown whether the General Assembly or another authority will consider extending the program based on the pilot outcomes.

Openings for the program were determined proportionately across the state based on obesity statistics from the Centers for Disease Control and Prevention. Patients who were recommended by their doctors were enrolled on a first-come, first-served basis.

When the provisos creating the pilot came up in the state budget debate in 2010, Sen. Greg Ryberg, an Aiken County Republican who has since retired, rejected what he referred to as “lap-band” surgery.

“This is why people distrust politicians. This is the reason they think that politicians are crazy. And politicians prove taxpayers right when they spend their money like this,” Ryberg had written in a blog posting.

“I drive by parks, tracks and neighborhoods, and at every hour of the day there are people walking, jogging, cycling, rollerblading, etc.

These are the lifestyles we should be rewarding.”

There are clear disagreements over how to control obesity-related costs and where responsibility should lie. But the reality of the Palmetto State’s health plight is not easily dismissed.

At 30.9 percent, South Carolina had the eight-highest obesity rate in the nation, according to a report released in February by the Trust for America’s Health. Georgia tied South Dakota for 17th place with a rate of 28.7 percent.

The report also said more than one quarter of the nation’s health care costs are related to obesity. It also estimated health care costs of obese workers to be up to 21 percent higher than for other workers.

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